Multi-visceral resection for locally advanced gastric cancer.

Fifty-three of sixty-four patients who underwent gastrectomy for gastric carcinoma presented with advanced gastric cancer. 8 patients underwent palliative gastrectomy. In 17 patients gastrectomy and lymphadenectomy was performed. In 28 patients with locally advanced gastric carcinoma, extended resection was performed. Patients who underwent splenectomy were only included if tumorous adherence to the spleen was present. Hospital mortality and morbidity were 3.6% and 25% in extended resection and 5.9% and 18% in gastrectomy and lymphadenectomy alone. R0 resection was performed in 26/28 and in 16/17 patients, respectively. In R0 (complete) resections the mean one and two-year-survival rates were 64% and 44% in extended resection, and 67% and 47% in gastrectomy and lymphadenectomy. In patients (11) with residual tumour (R1/R2) mean one and two-year-survival rates were 27% and 0%, respectively. If complete resection (R0) is achieved, extended resection for locally advanced gastric carcinoma provides survival time, which is comparable, stage for stage, with survival rates observed after R0 resection for cancer limited to the stomach.